Objective To observe the effect of nalbuphine combined with hydromorphone at different com⁃ patible dosages postoperative analgesia in gynecological laparoscopic patients. Methods The patients hospitalized in the hospital for selective laparoscopy were randomly divided into five groups according to the compatible doses： nalbuphine 0.75 mg/mL + hydromorphone 25 μg/mL（Group A），nalbuphine 0.67 mg/mL + hydromorphone 33 μg/mL （Group B），nalbuphine 0.50 mg/mL + hydromorphone 50 μg/mL（Group C），nalbuphine 0.33 mg/mL + hydromor⁃ phone 67 μg/mL（Group D），nalbuphine 0.25 mg/mL + hydromorphone 75 μg/mL（Group E）. VAS Pain Scores were recorded at PACU and at 4 h，8 h，12 h，24 h after operation. The total pressing times and effective pressing times of PCIA，adverse reactions and analgesic satisfaction were recorded. Results The VAS scores during activity at 8 h，12 h，24 h after operation，total pressing times and effective pressing times of PCIA in Group A were signif⁃ icantly higher than those of other groups（P < 0.05）. The incidence of nausea and vomiting in groups D and group E was significantly higher than that in the other three groups（P < 0.05）. The analgesic satisfaction was higher in Group B and Group C than that in the other three groups（P < 0.05）. Conclusion Nalbuphine 0.67 mg/mL combined with hydromorphone 33 μg/mL and nalbuphine 0.50 mg/mL combined with hydromorphone 50 μg/mL for PCIA can obtain satisfactory analgesic effect after gynecological laparoscopic operation. The incidence of adverse reactions is the lowest and the patient′s analgesia satisfaction is the highest and therefore they are worthy of clinical application.